急诊PCI围术期行临时起搏器置入的路径选择

Path selection of emergency PCI perioperative temporary pacemaker placement

目的:探讨急诊PCI围术期行临时起搏器置入的较佳途径。方法:130例急诊经皮冠状动脉介入治疗(PCI)需行临时起搏器置入的急性心肌梗死(AMI)患者,随机分成3组,其中经锁骨下静脉路径置入临时起搏器的45例,经颈内静脉的43例,经股静脉的42例,记录3种路径首次穿刺成功率、2次穿刺成功率、总穿刺成功率、穿刺完成时间、置入完成时间、总的置入时间、并发症发生情况。结果:锁骨下静脉组首次穿刺成功率显著高于颈内静脉组、股静脉组,差异有统计学意义(P<0.01);2次穿刺成功率、总穿刺成功率比较差异无统计学意义(P>0.05)。锁骨下静脉组穿刺完成时间、置入完成时间、总的置入时间比其它两组短,差异有统计学意义(P<0.05)。锁骨下静脉组并发症发生率明显低于颈内静脉组和股静脉组,差异有统计学意义(P<0.05或P<0.01)。结论:在急诊PCI围术期,经锁骨下静脉路径置入临时起搏器具有穿次成功率高、置入用时短、术后并发症发生率低、易被患者接受等优势。

Objective：To explore emergency PCI perioperative line temporary pacemaker in the better way .Methods ：To 130 cases of emergency Percutaneous Coronary intervention （PCI） requires a temporary pacemak-er placement of Acute Myocardial Infarction （AMI） patients divided themselves into three groups according to ran-dom number table randomly .Among them via subclavian vein path in 45 cases of temporary pacemaker ,43 cases of internal jugular vein ,42 cases of femoral vein ,Record three path puncture success rate for the first time ,2 times puncture success rate ,total success rate of puncture ,puncture complete time ,placement time ,the overall placement time and complications incidence .Results ：Success rate of first puncture of subclavian vein group was significantly higher than that in internal jugular vein and femoral vein group （P〈0 .01） ,the difference was statistically signifi-cant .2 times puncture success rate ,total puncture success rate comparison difference has no statistical significance （P〉0 .05） .Puncture of subclavian vein group complete time ,placement time ,the overall placement time ,shorter than the other two groups ,the difference was statistically significant （P〈0 .05） .The incidence of complications of subclavian vein group was obviously lower internal jugular vein and femoral vein group ,the difference was statistical-ly significant （P〈0 .05or P〈0 .01） .Conclusion ：In emergency PCI perioperative ,via subclavian vein path into tem-porary pacemaker has a high success rate in time ,in short ,lower incidence of postoperative complications ,the ad-vantages of the easily accepted by patients .